Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Friday, January 18, 2008

We get a lot of colon biopsies to look at. This is due to a huge effort by all the professional societies involved in gastroenterology to shove a tube up everyone’s ass. It serves a dual purpose: screen for cancer and make GI scope-jockeys incredibly rich. I’m all for it.

The Japanese have led the charge on this practice. You have probably heard the well-known American expressions: “Grass on the infield: Play Ball!”, or: “Old enough to pee; old enough for me”, or: “Old enough to eat; old enough to be eaten”. Well, in Japan the ancient saying goes: “Old enough to shit; old enough to have a flexible colonoscope inserted to your terminal ileum, then drawn out slowly while taking biopsies of suspicious polyps”. Believe me, it sounds much more clever and pithy in the original Japanese.

I got a polyp to look at under the microscope the other day and, like one might expect, there was some fecal material along with the tissue. This is usually due to a “poor prep”, a.k.a. “I ate a corn muffin and 20 munchkins before coming in today”. Amazingly, it is possible to microscopically identify what that person ate in most cases. Sure, there is a lot of digested sludge that is basically a mass of bacteria and degenerated goo. But, if you are lucky, you may see a leafy vegetable; some steak; and, of course, CornNuts®. Anyway, this poo was different. There was some sort of seed structure that looked unusual. I showed it around and was greeted with shrugs (how is shit NOT interesting!?). I probably could have dropped it there but I actually know a botanist, so I gave her the slide. A couple days later she called me and said, “It looks weird because it is germinating”.

The dude was growing a bean sprout in his colon. I’m thinking: New England Journal of Medicine: “Ass-plants: a case report and review of the literature”. Move over Jonas Salk, step aside Louis Pasteur; I’m going to Disney World, bitches!